Lexapro, generic name escitalopram, is a member of the drug class selective serotonin reuptake inhibitors (SSRIs). Doctors prescribe Lexapro to treat major depressive disorder (MDD) in adolescents and adults and generalized anxiety disorder (GAD) in adults. Lexapro is also used to manage other anxiety disorders, such as social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), and panic disorder with or without agoraphobia. This medication has also been demonstrated to be effective at reducing symptoms of premenstrual syndrome in women.
Approved for use in adults and children above age 12, Lexapro is available in oral tablet and liquid forms. Like other SSRIs, it works by increasing serotonin levels in the brain. Because serotonin helps regulate mood, higher levels of this chemical in the brain lessen depression and anxiety symptoms.
Being properly informed about medication side effects is an important part of patient-centered healthcare, as this information can help one decide if they are comfortable taking a drug. This article is a comprehensive guide to Lexapro’s side effects and will help you determine whether this medication could be beneficial to you.
Overview of Lexapro’s side effects
A side effect, also known as an adverse effect or reaction, is an undesirable and unintended reaction to a drug. Adverse reactions can be mild or severe. Mild side effects usually do not require medical attention and resolve on their own with time. However, severe or long-term side effects may require continual monitoring by a healthcare professional. Because individuals react to medications differently, not everyone experiences the same side effects.
Lexapro can cause both mild and severe or long-term side effects. Common mild side effects of Lexapro include headache, nausea, and sexual dysfunction. Serious side effects include serotonin syndrome, suicidal ideation, and unusual or allergic reactions.
People with other chronic illnesses, such as diabetes, hypertension, or bipolar disorder, are at higher risk of developing severe side effects. It is important to visit your doctor often to ensure that any side effects you experience are managed properly.
Addressing specific concerns about Lexapro
Lexapro’s common side effects
Lexapro’s side effects vary across users. Most are mild, typically presenting at the beginning of treatment and resolving with time as the body adjusts to the drug. You should seek medical attention, however, if you experience such side effects for more than six weeks. Lexapro users may experience the following common side effects:
In adults:
- Diarrhea or constipation
- Nausea and vomiting
- Headache and dizziness
- Drowsiness
- Difficulty sleeping
- Muscle aches and cramps
- Increased sweating
- Dry mouth
- Decreased appetite
In children:
- Nosebleeds
- Increased thirst
- Slowed growth and weight loss due to decreased appetite
- Heavy menstrual periods
Lexapro’s serious side effects
Although rare, Lexapro can cause some serious side effects. You should call your doctor immediately if you notice any of the following signs and symptoms:
- Increased suicidal thoughts and/or behavior or worsening depression, which are more likely to occur in children and young adults with a personal or family history of mental illness or psychiatric disorders
- Signs of serotonin syndrome, which include agitation, hallucinations, overactive reflexes, muscle twitching, rapid heartbeat, very high or very low blood pressure, fever, and muscle stiffness
- Severe allergic reaction, which may manifest as hives; swelling of the face, hands, throat, or eyes; difficulty breathing and/or swallowing; and/or rapid heartbeat
- Hyponatremia (low salt level in the blood), which can cause confusion, muscle twitching, headache, inability to concentrate, weakness, seizures, and/or loss of coordination
- More frequent or intense seizures in those prone to seizures, such as those diagnosed with epilepsy
- Signs of drug interaction when taking other medications used to treat bipolar disorder, most notably an increase in manic episodes, which are characterized by greatly increased energy levels, difficulty sleeping, reckless behavior, racing thoughts, excessive happiness or irritability, and fast and excessive speech
- Abnormally widened pupils, which can trigger development of glaucoma, causing severe eye pain, headaches, vision changes, and swelling in and around the eyes
- Sexual dysfunction, including a lack of interest in sex, inability to reach orgasm, inability to have or keep an erection, and loss of sensation in the genitals
- Unusual bleeding or bruising, especially if you are taking anticoagulants, which increase risk of bleeding gums and prolonged bleeding from small cuts
Commonly asked questions about Lexapro
Does Lexapro have withdrawal symptoms?
Doctors usually recommend taking Lexapro for a few years or until the user feels they no longer need the drug or decides to change medication due to side effects. However, stopping Lexapro is not a simple process and should not be taken lightly, as those who stop Lexapro abruptly or without guidance from a healthcare provider can experience severe withdrawal symptoms.
Emotional signs and symptoms of Lexapro withdrawal include the following:
- Anxiety
- Difficulty concentrating
- Depersonalization
- Worsening depression
- Increased irritability
- Mood swings
- Suicidal thoughts
- Panic attacks
- Aggressiveness
Physical signs and symptoms of Lexapro withdrawal include the following:
- Brain zaps (i.e., feelings of electric shocks running through the brain)
- Dizziness
- Headache
- Decreased ability to sleep
- Increased or decreased appetite
- Frequent urination
- Altered perception of taste and smell
- Muscle tension
- Chills
- Drowsiness
- Akathisia (psychomotor restlessness)
How soon does Lexapro take effect?
Individual responses to prescription drugs vary. Some people notice improvements in their condition more quickly than others. Although brain serotonin levels can increase as soon as a few hours after taking Lexapro, it may take several weeks before a user notices any improvement in their condition. Improvements in sleep, energy levels, and appetite are a few signs that Lexapro has started to take effect. Some people notice such changes one to two weeks after starting treatment, but other symptoms of depression may take at least six weeks to noticeably improve.
When starting a prescription drug, be patient and consistent. Some people starting Lexapro notice a period of increased anxiety or side effects before positive and lasting changes occur. Always follow your doctor’s advice and maintain follow-up consultations to discuss your progress and any concerns you have.
What happens if I miss a dose of Lexapro?
It is best to take Lexapro at the same time every day, as maintaining a regular schedule can help you remember, reducing the likelihood of a missed dose. Too many missed doses can cause antidepressant discontinuation syndrome, a set of withdrawal symptoms prompted by stopping or reducing an antidepressant after at least one month of use.
If you miss a dose of Lexapro, take it as soon as you remember that same day. However, if it’s close to the time of your next scheduled dose, it’s usually better to skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for the missed dose, as this can increase the risk of side effects.
Do Lexapro side effects go away?
Lexapro’s side effects may be mild or severe and depend on your health status (e.g., whether you have a mental illness, such as bipolar disorder), interactions with other drugs you are using, and the dosage prescribed by your doctor. Side effects usually occur within the first two weeks of using the drug, prompting some people to stop taking it. However, these symptoms usually gradually diminish as the medication’s intended effects start to kick in after about two weeks.
Can I drink alcohol while on Lexapro?
The U.S. Food and Drug Administration claims that clinical trials have not shown a solid link between alcohol use and decreased cognitive and motor impairments among people on Lexapro. However, doctors still advise Lexapro users to avoid alcohol or to consume in moderation, as it may worsen Lexapro side effects. Drinking alcohol while on Lexapro may cause worsening depression, drowsiness, increased anxiety, liver damage, or alcohol dependence.
The risk of alcohol-related issues increases as Lexapro dosage increases. For example, those who consume alcohol while taking 20 mg of Lexapro or more are at increased risk of side effects, especially increased suicidal thoughts and behavior. Therefore it is best to avoid alcohol when taking Lexapro.
Additional FAQs about Lexapro side effects
Practical tips for coping with Lexapro side effects
Here are a few practical tips for coping with Lexapro side effects:
- Maintain continual dialogue with your healthcare provider and set frequent follow-up visits so you can be advised on coping with your specific side effects
- Take your Lexapro dose with food to minimize nausea
- Maintain a healthy diet that includes high water, fruit, and vegetable intake
- Avoid driving long distances or operating heavy machinery until you know how Lexapro affects you
- As Lexapro can cause insomnia, take it in the morning instead of later in the day
- Include in your schedule regular exercise, such as swimming, yoga, or running
- Talk to your partner about Lexapro’s sexual side effects, as you may need to find creative ways to be intimate
Lexapro drug interactions
Taking other medications along with Lexapro can change how the drug works in your body or increase your risk of side effects. Some Lexapro drug interactions can be life-threatening. Here are some drugs and supplements to avoid while on Lexapro:
- NSAIDs, anticoagulants, omega-3 fatty acids, vitamin E, and garlic supplements, which can cause unusual bleeding
- Cimetidine, which can increase Lexapro levels in the blood and thus the risk of side effects
- St. John’s wort, ginseng, dextromethorphan (DXM), migraine medications, monoamine oxidase inhibitors (MAOIs), and other SSRIs, which can lead to serotonin syndrome
- Diuretics (e.g., furosemide), which can lower salt level in the blood
- Benzodiazepines, which can cause drowsiness or fatigue
The importance of treatment adherence
Managing major depressive disorder and generalized anxiety disorder can be difficult, especially with the high cost of prescription drugs. However, adhering to your Lexapro treatment plan will ensure effective remission of symptoms. Taking your medication regularly is important, as missing doses too often can cause worsening depression or other withdrawal symptoms.
If the high cost of Lexapro is causing you to skip doses, contact The Rx Advocates. We can reduce your out-of-pocket costs by helping you apply for the Lexapro patient assistance program, which offers far greater savings than coupons or other discounts. With this program, you are guaranteed monthly access to Lexapro at a fraction of its retail cost, whether or not you are commercially insured, so you never have to worry about running out of this vital medication. Contact us today to find out if you qualify!
